According to the World Health Organization, there are 130 million cases of scabies globally at any one time. Anybody can contract this skin condition regardless of age, race, or environment. The good news is that it is a treatable condition and one that you can avoid with the right precautions.

What Is Scabies?

Scabies is a relatively common skin condition that is caused by mites known as Sarcoptes scabiei, or human itch mites, as they are otherwise known. It presents itself as an incredibly itchy rash that develops when the mites take up residence and lay eggs under the top layer of skin. It is in infestation rather than an infection, causing extreme and relentless itching. Scabies can strike in any environment but is most prevalent in extended care facilities, care homes and other areas where humans congregate or live in close quarters.

Stages and Types of Scabies

While there is only one species of mite that creates scabies, there are several different classifications of the condition. They include:

  • Typical scabies: This itchy rash presents itself on wrists, hands, and elsewhere on the body. However, the face and scalp are usually not affected.
  • Infantile scabies: As the name suggests, this classification affects children and infants and will usually present as a rash on the feet, hands, face and scalp.
  • Nodular scabies: This form of scabies creates larger itchy bumps under the armpits, in the groin, and on genitals.
  • Complicated scabies: This type of scabies is usually present with other skin conditions, such as impetigo or dermatitis, which can make it difficult to determine where the rash specifically occurs and under which of the above classifications it falls.

Symptoms and Causes

You usually won't know that you have scabies until a few weeks of coming into contact with an infected person or environment (bedding, clothes, furniture, etc.). It takes the mites time to burrow into your skin and lay their eggs. This period is known as incubation. Afterward, you will start to experience the following symptoms:

  • Extreme and relentless itching: You will usually notice this itching in one place, such as the hands or armpits. The itch is often worse at night and also after a shower or hot bath. Eventually, you will start to feel the itching all over your body, even in places where mites are not present.
  • Rashes: The scabies rash appears as lumpy and blotchy pimples and blisters and can appear anywhere on the body.
  • Mite tunnels: Also known as mite burrows, these fine lines appear on the skin and can usually be seen in the webbing between fingers and the inner area of the wrist.
  • Pre-existing skin conditions worsen: If you suffer from another skin condition, scabies will usually exacerbate it and cause more discomfort.
  • Crusting of the skin: If scabies goes untreated, your skin may become crusty and could become infected.

If you are infected, try your best not to scratch the skin, as this could introduce mites to other areas of your body. See your doctor as quickly as possible and start using the treatment they recommend immediately.

Prevention and Risks

While scabies is not a fatal condition in itself, if left untreated it could cause more severe bacterial conditions. Those most at risk are people with a weakened immune system, the young and elderly, and those living in care environments or institutions. The best way to prevent contracting scabies is to avoid any contact with the mite itself. Skin-to-skin contact is the most common form of transmission, but you will usually need prolonged contact with an infected person or environment. Human itch mites can typically live off the human body for up to 72 hours.

Diagnosis and Tests

If you suspect that you have contracted scabies, your regular doctor will be able to offer you an initial diagnosis. From here, and depending on your condition and whether any other skin conditions are present, you will be recommended a treatment to use and advised to arrange a follow-up examination if necessary. If you have complicated scabies that is having a severe effect on your skin, your doctor may recommend you to a dermatology expert for further examination and treatment.

Scabies is usually quite easy for a doctor to diagnose due to the appearance of the skin. The typical telltale sign is the burrow marks that are common with the Sarcoptes scabiei mite. Your doctor may also use what is known as the ink test to form a more confident diagnosis. This test is noninvasive and consists of ink being rubbed onto the itchy skin to show the burrow marks more clearly. In some cases, such as where other skin conditions are present, it may be necessary to take a sample of the affected skin and to test it in laboratory conditions.

Treatment, Procedures, and Medication

Scabies is most commonly treated by over-the-counter (OTC) topical treatments in the form of creams and moisturizers. The most commonly prescribed treatments are permethrin cream and malathion lotion. Malathion lotion is only available by prescription and is considered a second-line defense against mites due to its potential to cause respiratory problems if ingested. You will usually be prescribed permethrin first, and if this has no or little effect on the mites, a follow-up prescription of malathion lotion may be given. Both of these treatments use an insecticide to eliminate the scabies mite and its larvae from the skin. You will usually need to apply two treatments, a week apart. 

Healthy Lifestyle Tips

If you have been diagnosed with scabies, start treatment right away and follow these precautions to manage the condition for yourself and others:

  • Treat all other household members immediately with permethrin cream at the same time as the affected person to prevent exposure to the mites.
  • Launder all bed linen, clothing, and other fabrics with which the infected person may have been in contact. Use the hottest cycle possible if the materials allow.
  • Children can return to school once their treatment has been completed.
  • Healthcare workers who are close to and have contact with scabies sufferers can also use permethrin cream at the same time as the patient to prevent infection.
  • In community areas, information on scabies recognition and awareness should be shared.

Conclusion

Even though scabies is a common condition worldwide, it can be prevented and treated relatively simply with the right precautions and medication. Possibly the most important consideration is the avoidance of direct contact with people or areas that you know are infected. If you are responsible for people or areas that may be affected, it is important to arrange a treatment and management plan that controls the spread of the condition and keeps it under control. In doing so, you can ensure that scabies does not become a widespread problem for you and those around you.